Form Dr 0589 - Sales Tax Special Event Application

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DR 0589 (01/12/06)
Departmental Use Only
17
COLORADO DEPARTMENT OF REVENUE
P.O. BOX 13200
DENVER, COLORADO 80201
(303) 238-SERV(7378)
SALES TAX
SPECIAL EVENT
APPLICATION
REGISTRATION/ACCOUNT NUMBER
3.
Individual
1.
Do you have a sales tax account in Colorado?
Yes
No
Limited Partnership
IF YES, Registration Account # ___________________________________________________
General Partnership
Association
A
Event Location
2.
Corporation
City in which your event is being held
Incorporation Date: ________
Limited Liability Company
County in which your event is being held
ZIP
Other
1. Taxpayer Name (owner, partners or other business organization) (last, first, middle)
2. Trade Name/Doing Business As (if applicable)
3a. City in which your business is located
State
ZIP
B
3b. County in which your business is located
Telephone
(
)
4. Mailing Address (residence address, include unit #)
City
State
ZIP
County
Telephone
Federal Employer I.D. # (if unavailable, S.S.#)
(
)
5. Brief Description of Business/What do you sell?
(1) Owner/Partner Name (last, first, middle) If Corporation, give Corporation name
Social Security # (Fed. Emp. # if applicable)
1a.
Address (residence or P.O. Box, street, city, state, ZIP)
Telephone
C
(
)
1b.
(2) Owner/Partner Name (last, first, middle) If Corporation, give Corporation name
Social Security # (Fed. Emp. # if applicable)
2a.
Address (residence or P.O. Box, street, city, state, ZIP)
Telephone
(
)
2b.
If there are other partners, list on separate sheet using the same format.
PERIOD OF EVENT
FEES
D
FROM
TO
Indicate which applies to you
Single Event
E
Single Event
Multiple Event
License
$
0120-750
(999)
Multiple Event
I Declare under penalty of perjury in the second degree
License
$
0140-750
(999)
that the statements made in this application are true and
F
complete to the best of my knowledge.
Make check payable to the
$
TOTAL
(Signature required below)
• • • • •
Colorado Department of Revenue
Signature of Owner, Partner or Corporate Officer
Title
Date
If your check is rejected due to insufficient or uncollected funds, the Department of Revenue may collect the payment amount directly from your banking account electronically.

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